Active NPI
Kerin Elizabeth Nagle, APRN
- Family Nurse Practitioner
- Hartford, CT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 007963
- Practice address
- Community Health Services
500 Albany Ave
Hartford, CT 06120-2508 - Phone
- (860) 249-9625
- NPI assigned
- Dec 4, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | F09181069 | CT | |
| Family Nurse Practitioner | 363LF0000X | 007963 | CT | Primary |
Addresses
Primary practice location
Community Health Services
500 Albany Ave
Hartford, CT 06120-2508
Mailing address
500 Albany Ave
Hartford, CT 06120
Phone (860) 462-6764
Other names 1
- Kerin Elizabeth Gilligan
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190130000215 | CT | Practitioner - Nurse Practitioner | 7012254030 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- McLean Fund
Practice addresses (Care Compare)
631 Quaker S LN
West Hartford, CT 06110-1026
Phone (860) 231-6130
75 Great Pond Rd
Simsbury, CT 06070-1980
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 007963 | CT | MD | Clinical Social Worker |
| F09181069 | CT | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prohealth Physicians PC | Family | Current | Accepting new patients |
Locations
3 Farm Glen Blvd
Farmington, CT 06032
Phone (860) 284-5200
631 S Quaker Ln
West Hartfrd, CT 06110
Phone (860) 231-6130
115 Spencer St
Winsted, CT 06098
Phone (860) 738-5810
Interoperability endpoints
- kerin.nagle.npi1801366646.phpct@direct.optumcare.masshiway.net
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1543881600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662595200000",
"number": "1801366646",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 ALBANY AVE",
"city": "HARTFORD",
"state": "CT",
"postal_code": "06120",
"telephone_number": "860-462-6764"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "COMMUNITY HEALTH SERVICES",
"address_2": "500 ALBANY AVE",
"city": "HARTFORD",
"state": "CT",
"postal_code": "061202508",
"telephone_number": "860-249-9625"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NAGLE",
"first_name": "KERIN",
"middle_name": "ELIZABETH",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-12-04",
"last_updated": "2022-09-08",
"certification_date": "2022-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CT",
"license": "F09181069",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CT",
"license": "007963",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KERIN",
"last_name": "GILLIGAN",
"middle_name": "ELIZABETH",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Hartford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.